It’s a message that people who smoke and vape have heard a million times: Please quit. But during this coronavirus pandemic, it’s being delivered with added urgency.

Smokers and vapers are at higher risk of not being able to fight off the COVID-19 respiratory disease, and health care professionals must recognize them as a vulnerable group and ensure basic advice and access to medicines and therapies are available, say professors from UC Merced and its Nicotine and Cannabis Policy Center.

Given that people sometimes smoke as a way to cope with stress, breaking the addiction during perhaps the most stressful time in recent history is all that much harder, health experts understand. “Most smokers — and we’re talking 90 percent — wish they weren’t, and I really feel for them right now,” said Anna Song, UC Merced associate professor of health psychology and director of the NCPC.

Song spoke by phone with The Bee this week, joined by two NCPC colleagues: Mariaelena Gonzalez, assistant professor of public health, and immunologist Marcos Garcia-Ojeda, a teaching professor of molecular cell biology.

With the COVID-19 virus so new, and research “emerging as we speak,” a lot of what scientists know was learned from past COVID viruses, Song said.

Added Garcia-Ojeda, “We’re using its cousins SARS and MERS as the platform to build our knowledge on — taking what we know and building on that to understand COVID-19.”

An abundance of research shows that smoking (there’s less data on the much newer vaping) adversely affects the immune system, Gonzalez said. That’s true for not just the smokers themselves but for those exposed to secondhand smoke, she said.

“When you smoke, the effect happens immediately, even in the oral cavity,” Song said. “… From the get-go, it’s lowering your body’s ability to fight viruses, and having a functioning immune system is critical” as the coronavirus has the world in its grip.

Smoke, e-cigarette vapor dangerous

In an article on the website of the Sacramento public radio station Capradio, the director of the UC San Francisco Center for Tobacco Research Control & Education said the particles in smoke and e-cigarette vapor can get deep in the lungs and damage the cilia, the hairlike structures that help protect the respiratory system.

“Your whole pulmonary system is designed in a way to push viruses out,” Stanton Glantz said in the article. “Smoking and vaping destroy cilia that act like oars and push foreign material up out of your nose and out of your airways.”

Another issue being written about is that in some patients with severe COVID-19, the immune system is causing hyperinflammation, Garcia-Ojeda said, resulting in severe lung damage and organ failure. “You take a lung that’s already irritated (from smoking or vaping) and add a virus that’s causing dysregulation of the lung and you have a recipe for disaster.”

She’s not big on scare tactics, Song said, and doesn’t want smokers or anyone else to “ cower in fear when we can do something. There are incremental steps we can take to protect ourselves.”

Website nobutts.org can help

It’s vital to help the vulnerable population of smokers by giving them as many tools as possible to keep them safe, she said. It should be a priority to provide nicotine patches, counseling and other therapies. California has an extensive cessation program, including a hot line, 1-800-NO-BUTTS, and associated website, nobutts.org. “Directing people to this hot line is one of our strongest tools we have in getting people to stop,” Song said.

During this pandemic that has front-line health care workers stretched to their limits and non-urgent medical appointments being canceled left and right, it remains important for smokers who want it to be able to get help quitting, Gonzalez reiterated. Some antidepressants, she noted, including low-dose SSRIs (selective serotonin reuptake inhibitors) have proved to be effective smoking-cessation aids, she said.

Including but extending beyond smokers is that now more than ever, people need to be working to maintain and improve their immune systems and overall health, the professors said. That can include picking up hobbies again, making the most of time with family as you’re sheltering in place, maintaining social connections, practicing yoga, using a meditation app and more, Gonzalez said.

It means eating well, exercising and social distancing, Song added.

“What we currently have is a situation we’ve not seen in a hundred years, since the H1N1 Spanish flu,” Garcia-Ojeda said of the 1918-19 influenza pandemic. An article on the website of the national Centers for Disease Control and Prevention says about 500 million people, or one-third of the world’s population, became infected with the virus. The number of deaths was estimated to be at least 50 million worldwide, with about 675,000 occurring in the United States.

“People are stressed, and one coping mechanism is smoking,” Garcia-Ojeda said, “so we have to promote ways to reduce stress that don’t including picking up a cigarette.”